Dental 365 brings urgent-care model to the dentist's office

Cuomo awards $6.5M to combat sexual violence

Government agencies, hospitals and other nonprofits that promote sexual assault prevention and offer support services to survivors in New York will receive $6.5 million in grants to bolster their programs, Gov. Andrew Cuomo said Thursday.

The funding will support crisis hotlines, counseling, advocacy and therapy as well as education in schools, colleges and communities. Fifteen city organizations received nearly $1.9 million from the state grants. Those included hospitals such as Mount Sinai Beth Israel, Mount Sinai Hospital's Adolescent Health Center, New York-Presbyterian Hospital and its Domestic & Other Violence Emergencies Program, NYC Health + Hospitals/Bellevue and Wyckoff Heights Medical Center.

Dr. Angela Diaz, director of the Mount Sinai Adolescent Health Center on East 94th Street in Manhattan, said the state's $177,300 grant would finance an educational program at Harlem Renaissance High School that uses the Safe Dates curriculum, a program designed to prevent dating violence.

The Adolescent Health Center annually works with 11,000 clients ages 10 to 24 from the five boroughs and Westchester County. It also has full-time clinics in 24 high schools located within six buildings.

The front-page media coverage of women who have experienced workplace sexual assault and harassment may encourage more people who have experienced trauma to come forward, Diaz said. Of the center's female clients, about half have experienced sexual violence.

"What all this media coverage does is bring awareness all over the U.S. and globally that this happens so often," she said. "We know how often it happens, but most people are not aware." —J.L.

Northwell and Cigna reach contract

Northwell Health has agreed to a contract to stay in-network with Cigna a week after the insurer told members that Northwell would no longer be part of its network starting Jan. 1.

The deal covers the health system's hospitals, doctors, laboratories, home care and other services, and extends a more than 20-year relationship between the two sides. Cigna offers large-group plans in the New York market. A Northwell spokesman said the health system experiences 40,000 inpatient and outpatient visits from Cigna customers annually.

On Nov. 30, while the two sides struggled to reach a renewal deal, Cigna sent a letter to members telling them that Northwell would be out-of-network in 2018. It provided advice on how to find a new in-network hospital and aimed to comply with state regulations requiring notification of customers 30 days before a change in an insurer's network.

"We regret any confusion or inconvenience caused by Cigna's letter," Howard Gold, Northwell's executive vice president and chief managed-care officer, said in a statement.

A Cigna spokeswoman said the insurer would be sending out letters this week to notify customers that Northwell will remain in its network. —J.L.

NY's small-group market 'in distress,' report says

New York's small-group insurance market is "showing signs of distress" as enrollment declines and premiums rise, according to a new report from the United Hospital Fund. Enrollment dropped from about 1.7 million enrollees in 2007 to 1.1 million in 2016.

Last year small-group average monthly premiums reached $600, according to data collected as part of the federal premium stabilization program. That's 39% higher than in 2014 and 35% more than the $440 national average. Only Alaska had higher costs.

UHF suggested that higher premiums may be the result of a sicker population in the small-group risk pool. It noted that New York's risk score in 2016 was the highest in the nation.

The Trump administration issued an executive order Oct. 12 that instructed federal agencies to propose regulations allowing the sale of insurance across state lines and expand access to Association Health Plans. There is concern among New York policymakers, regulators, health plans and employers that such plans could further erode the small-group market by siphoning off healthier small-employer groups, UHF noted. "New York's rating rules and strong benefit standards make it a target-rich environment for entrepreneurs looking to market out-of-state or self-funded coverage in New York through AHPs, so all eyes here will be on the upcoming Trump AHP regulation," according to the report. —R.S.

AT A GLANCE

OPEN ENROLLMENT: Enrollment in the state's Qualified Health Plans and the Essential Plan is outpacing participation by 13% at the same point last year, the NY State of Health said Thursday. More than 66,000 new enrollees already have signed up for 2018 coverage, including more than 23,000 consumers who have enrolled in a QHP and nearly 43,000 who have enrolled in the Essential Plan.

COST SHARING: Insurers may have to pay back the government for funds they have already spent on low-income enrollees through 2017, Modern Healthcare reported. It's still not clear whether Congress will appropriate cost-sharing reduction payments. This means insurers may have to return any surplus they used to cover CSR costs since the Trump administration cut off the payments in October.

HEP C: The nation's opioid crisis has led to a spate of hepatitis C infections among people in their 20s, reported Kaiser Health News. The number of people in that age-group with acute hepatitis C infections approximately tripled from 2009 to 2015, according to data from the Centers for Disease Control and Prevention.

CORRECTION: Dr. Hila Richardson is the board chair of Isabella Geriatric Center. Her first name was misspelled in the Dec. 6 Health Pulse article, “Isabella Geriatric Center to join nonprofit MJHS Health System.”

Dental 365 brings urgent-care model to the dentist's office

A few doors down from the CityMD near Union Square, Dental365's glass storefront sports a glowing blue-and-white logo of a giant tooth with a heart inside it. Passers-by can peek through the window into the tidy waiting room with the company's signature blue chairs. Signs advertise the practice's extended hours and welcome walk-ins.

"Millennials love my business model," said Dr. Scott Asnis, co-founder and CEO of Dental 365, a chain of 14 urgent-care dental clinics in New York City and on Long Island. "You can come home from work and get dentistry done. You can get wisdom teeth taken out on Thanksgiving. You can get your teeth bleached on Christmas Day. It's just how health care is going."

Dental365's similarities to CityMD, a for-profit chain with more than 80 locations in three states, are no coincidence—nor is its tendency to pop up near the urgent-care behemoth.

The first Dental365 opened in 2013 in the back of a Premier Care medical clinic in Lynbrook, Long Island, a few months before the chain was acquired by CityMD.

Dr. David Kim, who was co-founder and chief executive of Premier Care, was happy to rent the space to Asnis, both his dentist and old golfing buddy.

Kim is now a partner in both CityMD and Premier Care Dental Management, the management group for Dental365. "The success story is almost the same, just with convenient dentistry," Kim said.

The urgent-care model—characterized by convenience, quality clinicians and strategic marketing—has the potential to take off in a range of medical specialties, including orthopedics, ophthalmology and veterinary care, said Kim.

"There are a lot of those initiatives that I'm looking into now," he added.

Solo dental practices are becoming increasingly rare in New York, as many young dentists choose to become employees rather than business owners. They may work for a chain for a couple of years to pay down their debt and eventually partner with other dentists to start their own practices to benefit from economies of scale, said Dr. Mark Feldman, executive director of the New York State Dental Association and a retired dentist.

"What we're seeing in dentistry at this point in time is frankly more generational," Feldman said.

The emergence of chains like Dental365 may spur other practices to expand their hours to stay competitive. "Access for patients is key, so if they make themselves more accessible, it's going to behoove other dentists to do the same thing," Feldman said.

Many of Dental365's locations are open seven days a week, and hours run as late as 8 p.m. on some weekdays. About 90% of the patients make an appointment.

The chain has started acquiring independent dental practices and is on track to open another five offices by early next year, bringing its total count to 19. Future expansion plans may include branches in Connecticut and New Jersey, Asnis said. All of Dental365's dentists are employees, but some owners of the practices it has acquired retain a small stake in the business.

While most people associate urgent-care with emergency services, Asnis said Dental365 strives to develop ongoing relationships with its patients and offers a variety of specialties. The company even employs oral surgeons and orthodontists.

Like many upscale practices in the city, Dental365 offers amenities to attract and retain clients, including a Roku media console in every exam room so patients can watch Netflix or listen to music during cleanings.

Asnis said his company's scale allows him to offer better prices than other high-end practices, but not everyone will be able to afford its services. Dental365 currently accepts some commercial insurance and offers its own in-house plan: Patients can pay $190 per year for two oral exams, two cleanings and X-rays. But it has no plans to start taking Medicaid.

The company, which is self-funding its expansion, sees an average of 1,400 new patients each month and now employs about 220 staffers, said Asnis, who admits he's surprised by Dental365's rapid growth. "We became a monster," he said. —C.L.

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